E-mail To David Sissling
From: Ian Perkin [ianperkin@blueyonder.co.uk]
Sent: 16 October 2004 21:34
To: 'david.sissling@lnrsha.nhs.uk'
Cc: 'michael taylor'; 'Julie.Dent@swlha.nhs.uk'; 'james.cochrane@swlha.nhs.uk';
'David.McNeil@doh.gsi.gov.uk'; 'Naaz.Coker@stgeorges.nhs.uk'; 'Peter.Homa@stgeorges.nhs.uk';
'nigel.crisp@doh.gsi.gov.uk'
Subject: Sissling Review
Dear Mr Sissling
I am writing to you having been supplied with a copy of your report by the South West London Strategic Health Authority. As you will no doubt recall (the tape recording of our meeting confirms this point), I made it clear at the outset of your investigation that I did not believe that the NHS was capable of mounting an independent and impartial investigation into the matters that I had previously reported to Sir Nigel Crisp. I am saddened, but not surprised, to find on reading the report that my fears were well founded and that I was absolutely correct to make it clear from the outset that I could only have faith in an investigation that was conducted by individuals completely independent of the NHS.
The fact that your report finds that in at least two major respects (misreporting of cancelled operations & inappropriate charging of hospitality by Ian Hamilton) the allegations that I made have been proven, does not mean that it has been conducted fairly. When I wrote to Mr Taylor requesting the names of those he was interviewing, he replied on the 28th May 2004 stating, " You will recall that when we first met I explained that the prime purpose of that meeting was for you to provide me with details supporting the six allegations and that we would need to meet again after oral and written evidence was placed before me by other interviewees. I do accept that as a result of the points raised at our second meeting you may wish to provide additional material". Despite this reassurance from Mr Taylor that I would be given the opportunity to supply him with additional material after he had spoken with other interviewees, his report makes a number of adverse comments about the performance of the Finance Department under my direction, particularly with regard to allegations 3 and 4 and in his final conclusions, where he suggests that under my direction the Trust Finance Directorate held an isolationist stance and that my professional views were in some way damaging to the Trust. Had Mr Taylor put these allegations to me specifically, (the tape recording of our second meeting confirms that he did not), I would have had no problem in providing both written evidence and a list of additional witnesses that he should have spoken to, which would have proved that these allegations were clearly false and were made without foundation. However, Mr Taylor's actions in not raising these matters with me are in stark contrast to the fact that with regard to the allegations that I was making, he clearly gave every opportunity for those accused to fully respond The allegations about me were therefore included in your report without me ever having had the opportunity to respond to them appropriately. As I was not afforded the opportunity to supply Mr Taylor with the clear evidence that shows that these allegations were untrue I shall be publishing this information in my book "Don't Blow The Whistle" to demonstrate not only the truth of what happened at St George's but to also demonstrate that your investigation was neither fair or impartial. The Honourable Mr Justice Mitting stated at the Employment Appeal Tribunal on 29th July 2004, "It was throughout clear that no criticism whatever could be made or was made of the Appellant's technical competence nor of his integrity", yet Mr Taylor has decided, without giving me the chance to respond, that untrue allegations about my professional conduct made by others is to be accepted without challenge. Indeed I note that even where I have provided Mr Taylor with the details of written evidence that supports the allegations that I have made, such as the copy of the e-mail from Lisa Ward the Minister of Health's press officer claiming that the adjustment to the accounts, to which allegation 4 relates, was in accordance with UKGAAP (UK Generally Accepted Accounting Practice), when of course your report confirms that the transaction was not in accordance with UKGAAP, he has chosen not not to include it within the appendices attached to the report. He has also not made reference to the fact that the Chief Executive of the Audit Commission has acknowledged that from the current accounting year the loan aspect of this kind of transition has now to be acknowledged in the accounts, rendering these type of adjustments pointless. The fact that there has been no legislative change since the original adjustment was put in place and UKGAAP has not changed over the intervening period, simply reinforces the point that if it is wrong not to show the loan aspect of such a transaction in 2004/05 accounts, it had to be equally wrong not to show the loan aspect of such a transaction in 2000/01. Again I am content to publish the detail of this transaction in my book, "Don't Blow The Whistle" and allow my peers within the accounting profession to decide who is in the right regarding this matter. I have absolutely no doubt as to the conclusion that will be reached.
I have much more relevant written information which I shall be referring to in my book, but there are three further points major points that I would wish to highlight.
Firstly I note that the appendices included in support of allegation 3 do not include the actual calculations made by Dr Ghodse which demonstrate just how with the approval of the Chief Executive and Chairman and other Board Members made a mockery of the whole NHS costing system. An independent report would not have omitted such a damming document. The NHS is not a market and should make its decisions on the basis of information accurately recorded and shared in good faith. Again I am happy to publish this information and Mr Taylor's comments that he comes to the conclusion that patients did not suffer and do not continue to suffer from NHS Trust's deliberately trying to mislead commissioners as to the costs of providing particular services. Mr Taylor demonstrates his complete lack of understanding of how an organisation as complex as the NHS needs to organise it's financial costing arrangements, if resources are not to find their way to inefficiently run organisations, rather than to the inefficiently managed organisations, simply because they are better at cheating the system. Again I am content to publish the information and allow my peers to judge who is right regarding this matter. I do not believe a proper investigation independent of the NHS would have come to anything but an extremely critical conclusion about the practices that Mr Hamilton encouraged to take place at St George's regarding this issue and from the comments made by Mr Taylor how the wider NHS similarly conducts itself.
My second point concerns the conclusion reached about the reference given for Mr Tomadj by Mr Dillon. The excuse about legal advice being taken about the content of the reference is simply irrelevant. Mr Dillon was not giving a reference to an external organisation he was simply passing information to another branch of the same organisation. The parallel would be to suggest that if the Tooting branch of Marks and Spencer had similar problems with an employee, who subsequently applied for a job at their Kingston branch, they would not inform them of the employees history. I don't think anything more needs to be said on this subject and again I shall make clear reference to the reasoning given in your report so that others can judge whether this is a reasonable stand for the NHS to take.
The third point concerns the comments made by Mr Taylor regarding Mr Hamilton's charging the cost of a private party at the Savoy Hotel to the public purse. Mr Taylor says I am at fault for not having raised my unease at that time to the Audit Committee. This is in my opinion a clear example of the lack of fairness and balance applied to Mr Taylor's investigation. In considering criticisms of myself and my department there is not a single written complaint having been recorded about the performance of either myself or my department. Indeed the Chairman of the Audit Committee David Knowles confirms this in the evidence he gave to the KPMG on the 24th July just five days before I was asked to resign when he stated that no complaints had been received by the Audit Committee concerning my performance or the performance of my directorate and that there was not much additional financial information reporting that they wished to take on which my directorate was not already providing. I note that Mr Taylor while relying on some statements made to KPMG does not refer to Mr Knowles evidence. In the interests of fairness Mr Taylor cannot have it both ways. If he thinks I was at fault for not raising the Savoy issue with the Audit Committee, how can he accept criticisms made by others of me if they had never been raised with me in the first instance and it has been confirmed that they had not been raised with the Audit Committee. Mr Taylor says that I reacted badly to scrutiny of my department that took place between 1999 and 2002, there is absolutely no evidence to justify this conclusion. I have already pointed out that Mr Taylor did not raise these issues with me directly at either of our meetings and there is not a single written complaint about my directorate to which Mr Taylor can point, he relies entirely on the oral evidence of individuals who have lost their integrity by the actions they have taken, in having conducted a disciplinary hearing in breach of the ACAS code of conduct, in having lied when giving evidence under oath and by their actions in seeking to have provided a range of excuses as to why the Cancelled Operations figures were altered. It is clear that in conducting the investigation Mr Taylor has relied heavily on the verbal evidence of these individuals and has taken no account of why they would have a vested interest in lying. Why if things were so bad as it is claimed did no one make a formal complaint to which they can now point to in support of their untrue claims. The external auditor PricewaterhouseCoopers stated in their management letter for the financial year 2000/01 “We have commented in the past on the strength of the finance function at the Trust and consider that with its skills it may be well placed to contribute significantly to the Shared Services Initiative”. A somewhat strange comment for an external auditor to make about a Finance Department that according to Mr Taylor was isolationist and which according to him, had been becoming increasingly dysfunctional since 1999!!! I don't think any further comment need be made regarding this issue other than that I shall be drawing attention to the obvious lack of consistency in the approach that Mr Taylor has used in drawing his conclusions when I publish my book.
For your information I shall be publishing this letter on my website and will be going into much more detail in my book regarding this unsatisfactory investigation. Mr Taylor is quite correct when he says I do not accept that NHS wide systems work well and your report is just another example of institutional failure on the part of NHS management. Until the NHS faces up to the realities of telling the truth and not trying to hide the fact that it has many intractable problems to deal with, it will never reach a position where management can properly support the often gifted and dedicated staff who have to work so hard to provide the front line services. Trying to discredit those that are prepared to expose those that lie and cheat within the system will never lead to the provision of a safe and efficient health service.
Yours sincerely
Ian Perkin CPFA FRSA